Coronavirus: Difference between revisions

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==Background==
==Background==
Coronaviruses are enveloped, positive-stranded RNA viruses that commonly cause up to one-third of upper respiratory tract infections in adults and children. Coronaviruses are also thought to cause diarrhea in infants and children.
* Enveloped, positive-sense single-stranded RNA viruses with nucleocapsid
* Very common cause of [[upper respiratory infection]], especially during fall and winter, and some diarrhea in pediatric patients
* Emerging pathogen for respiratory disease outbreaks
* Probably originated from bats, then spread to other mammalian hosts
** [[SARS]]-CoV – Himalayan palm civets
** [[MERS]]-CoV – Dromedary camels
** [[COVID-19|SARS-CoV-2]] – Suspected to be from pangolins
 
{{Specific Coronavirus Sub-Types of Clinical Importance}}


==Clinical Features==
==Clinical Features==
 
*Incubation period: 2-4 days
Pulmonary - symptoms include coughing, signs of an asthma exacerbation, and in elderly or immunocompromised patients can even cause respiratory failure<br />
*Upper respiratory symptoms
 
**[[Rhinorrhea]], [[cough]], [[sore throat]], earache, [[fever]], malaise
GI - vomiting, diarrhea, in neonates it is thought to possibly even cause [[Necrotizing enterocolitis]]<br />
**Respiratory symptoms may be more severe in elderly/immunocompromised (e.g. [[pneumonia]], secondary bacterial [[pneumonia]])
 
*GI symptoms - [[vomiting]], [[diarrhea]], [[Necrotizing enterocolitis]] (in neonates)
HEENT - otalgia, coryza, rhinorrhea, sneezing


==Differential Diagnosis==
==Differential Diagnosis==
*[[Rhinovirus]]: most common cold virus.  Causes around 40% colds.
**as opposed to Coronavirus, this causes cold in other seasons besides winter.
**Rhinovirus is NOT encapsulated as opposed to Coronavirus.
*[[respiratory syncytial virus]] (RSV)
*[[influenza]]
*parainfluenza


==Evaluation==
==Evaluation==
*PCR Testing
**Should be obtained on nasopharyngeal swab preferably one with synthetic fibers and plastic tip and under isolation
**Criteria for who to test is constantly evolving at this time. The CDC currently recommends clinicians to refer to local and/or institutional guidelines and test availability when deciding who should be tested.
*Laboratory Abnormalities
**Lymphocytosis
***Present in 70-80% of patients<ref name="clinical characteristics">Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China [published online ahead of print, 2020 Feb 7]. JAMA. 2020;10.1001/jama.2020.1585. doi:10.1001/jama.2020.1585</ref>
***Severity of lymphocytosis and leukopenia shown to be associated with severe of illness<ref name="clinical characteristics"></ref><ref name="disease 2019">Wei-jie Guan, Ph.D., Zheng-yi Ni, M.D., Yu Hu, M.D., et al. Clinical Characteristics of Coronavirus Disease 2019 in China. China Medical Treatment Expert Group for Covid-19. The New England Journal Of Medicine website. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 Published February 28, 2020. Accessed March 31, 2020</ref>
**Thrombocytopenia, elevated lactate dehydrogenase, elevated C-reactive protein, and prolonged prothrombin time have been reported<ref name="clinical characteristics"></ref><ref name="disease 2019"></ref>


==Management==
==Management==
There is currently no recommended treatment for corona virus infections other than supportive care. During the 2002-2004 SARS outbreak, several antiviral agents were created, but their efficacy was never clearly established.
*There is no specific treatment for Coronavirus, since most infections spontaneously resolve. 
*Supportive care, no specific treatment
**Rest, hydration, [[analgesia]], antipyretics
*Hand hygiene to prevent spread
 
==Disposition==
 
==Prevention==
*The first vaccines produced against a coronavirus were developed during the [[COVID-19]] pandemic
*Measures to reduce risk of transmission: fully wash hands, do not touch face without washing hands, avoid close contact with sick contacts.


==See Also==
==See Also==
*[[Upper respiratory infection]]
*[[Fever]]
*[[COVID-19]]


==External Links==
==External Links==
*http://www.cdc.gov/coronavirus/about/
*https://en.wikipedia.org/wiki/Coronavirus


==References==
==References==

Latest revision as of 23:41, 6 March 2021

Background

  • Enveloped, positive-sense single-stranded RNA viruses with nucleocapsid
  • Very common cause of upper respiratory infection, especially during fall and winter, and some diarrhea in pediatric patients
  • Emerging pathogen for respiratory disease outbreaks
  • Probably originated from bats, then spread to other mammalian hosts
    • SARS-CoV – Himalayan palm civets
    • MERS-CoV – Dromedary camels
    • SARS-CoV-2 – Suspected to be from pangolins

Specific Coronavirus Sub-Types of Clinical Importance

Clinical Features

Differential Diagnosis

  • Rhinovirus: most common cold virus. Causes around 40% colds.
    • as opposed to Coronavirus, this causes cold in other seasons besides winter.
    • Rhinovirus is NOT encapsulated as opposed to Coronavirus.
  • respiratory syncytial virus (RSV)
  • influenza
  • parainfluenza

Evaluation

  • PCR Testing
    • Should be obtained on nasopharyngeal swab preferably one with synthetic fibers and plastic tip and under isolation
    • Criteria for who to test is constantly evolving at this time. The CDC currently recommends clinicians to refer to local and/or institutional guidelines and test availability when deciding who should be tested.
  • Laboratory Abnormalities
    • Lymphocytosis
      • Present in 70-80% of patients[1]
      • Severity of lymphocytosis and leukopenia shown to be associated with severe of illness[1][2]
    • Thrombocytopenia, elevated lactate dehydrogenase, elevated C-reactive protein, and prolonged prothrombin time have been reported[1][2]

Management

  • There is no specific treatment for Coronavirus, since most infections spontaneously resolve.
  • Supportive care, no specific treatment
  • Hand hygiene to prevent spread

Disposition

Prevention

  • The first vaccines produced against a coronavirus were developed during the COVID-19 pandemic
  • Measures to reduce risk of transmission: fully wash hands, do not touch face without washing hands, avoid close contact with sick contacts.

See Also

External Links

References

  1. ↑ 1.0 1.1 1.2 Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China [published online ahead of print, 2020 Feb 7]. JAMA. 2020;10.1001/jama.2020.1585. doi:10.1001/jama.2020.1585
  2. ↑ 2.0 2.1 Wei-jie Guan, Ph.D., Zheng-yi Ni, M.D., Yu Hu, M.D., et al. Clinical Characteristics of Coronavirus Disease 2019 in China. China Medical Treatment Expert Group for Covid-19. The New England Journal Of Medicine website. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 Published February 28, 2020. Accessed March 31, 2020
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